Abstract
The incidence of PCP at the University of Florida during the 12 months period 10/75 to 10/76 was 6.8%(10/147 children treated with intensive chemotherapy). Primary diagnoses included: 7 leukemia and 3 solid tumor patients. 4/7 ALL patients were in remission(median duration 91.5 days); 3 leukemia and 2 solid tumor patients were in relapse.
Presenting symptoms: fever-10/10; cough-9/10; tachypnea-6/10 and dyspnea-3/10. In 9/10 cases an interstitial pneumonitis was revealed on x-ray and a lung biopsy was performed within 24 hours following this finding. In one child, first in our series, an abnormal x-ray was present 4 weeks before biopsy.
The method of diagnosis, thoracoscopy, was performed under intramuscular anesthesia, without endotracheal tube. It allowed for direct observation and intrathoracic biopsy. Equipment utilized for this procedure was the Karl Stolls peritoneoscope set employing the Hopkins fibroscope and biopsy forceps. The method proved safe even in seriously ill patients and complications were minimal. 1 case of pneumothorax was resolved by reposition of tubing and there was 1 case of mild subcutaneous emphysema.
All patients were treated with TPM 20mg/kg/d and SMX 100mg/kg/d 7 patients recovered, symptoms improved within 4 days after therapy was begun. 3 patients died, 2 patients had progressive tumors, 1 was complicated by sepsis. The cure rate in this incidence was 70%.
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Hvizdala, E., Rodgers, B. & Komp, D. PNEUMOCYSTIS PNEUMONIA (PCP) IN CHILDHOOD CANCER: NEW METHOD OF LUNG BIOPSY AND RESULTS OF THERAPY. Pediatr Res 11, 501 (1977). https://doi.org/10.1203/00006450-197704000-00787
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DOI: https://doi.org/10.1203/00006450-197704000-00787